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General NPI Number Information
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NPI Number | 1538413703
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Entity Type | Organization
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Legal Business Name | WOODLAND PARK OBGYN LLC
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 1031 MCBRIDE AVE SUITE D206
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-2559
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Country | US
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Telephone | 973-785-2131
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 MCBRIDE AVE SUITE D206
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-2559
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Country | US
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Telephone | 973-785-2131
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES HADDAD
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Credential | M.D.
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Telephone | 973-574-1006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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